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10.1016/j.clinpr.2021.100089

http://scihub22266oqcxt.onion/10.1016/j.clinpr.2021.100089
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suck abstract from ncbi


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pmid34426799      Clin+Infect+Pract 2021 ; 12 (ä): 100089
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  • Compassionate use of REGN-COV2 in the treatment of COVID-19 in a patient with impaired humoral immunity #MMPMID34426799
  • Nguyen H; Salkeld J; Agarwal S; Goodman A
  • Clin Infect Pract 2021[Nov]; 12 (ä): 100089 PMID34426799show ga
  • BACKGROUND: The role of antibodies in coronavirus disease 2019 (COVID-19) in patients with X-linked agammaglobulinaemia (XLA) has yet to be characterised and clinical courses observed in this cohort of patients have been heterogeneous. Whilst some exhibit spontaneous recovery, others have experienced a more protracted disease length. Previous reports have described successful use of convalescent plasma, however there is a paucity of information around the use of the REGN-COV2 antibody cocktail in these patients. CASE REPORT: A patient with XLA was admitted to hospital with COVID-19 and remained persistently symptomatic with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab positivity despite treatment with Remdesivir and dexamethasone. Attempts at modulating the immune response with anakinra were unsuccessful. Consent for compassionate use of REGN-COV2 was obtained with administration taking place on day 87 of his illness. This was followed by a period of convalescence and SARS-CoV-2 nasopharyngeal swab negativity. As a consequence of prolonged immunosuppression, the patient developed pneumocystis pneumonia. CONCLUSION: This case highlights the role of antibodies in clearing SARS-CoV-2 in a hypogammaglobulinaemic host and demonstrates the consequences of prolonged immunosuppression and delayed treatment. We propose that this may be of particular significance given the capacity of SARS-CoV-2 to develop advantageous mutations in a chronically infected host.
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